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NPI Code Detail

MEDICARE: MRS. SUSAN NEMINSKI BSW,CAC I

MEDICARE: MRS. SUSAN NEMINSKI BSW,CAC I
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor1-01297MI

General Provider Information

NPI Number : 1518077213
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN NEMINSKI BSW,CAC I
Provider Business Mailing Address
First Line : 3750 MARATHON RD
Second Line :
City : COLUMBIAVILLE
State : MI
Zip : 48421-8993
Country : US
Telephone Number : 810-356-4802
Fax Number :
Provider Business Practice Location Address
First Line : 1800 IMLAY CITY RD
Second Line :
City : LAPEER
State : MI
Zip : 48446-3208
Country : US
Telephone Number : 810-245-4802
Fax Number : 810-245-5676
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 07/08/2007

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